Dietary Pattern’s Role in Hepatic Epigenetic and Dietary Recommendations for the Prevention of NAFLD
Abstract
:1. Introduction
1.1. DNA Methylation
1.2. Histone Modifications
1.3. MicroRNAs
1.4. Influence of Dietary Patterns in Metabolic Diseases
2. Methods
2.1. Study Selection, Inclusion and Exclusion Criteria
2.2. Screening and Eligibility Criteria
3. Results and Discussion
3.1. Epigenetic Modulation of MEDITERRANEAN, Low Fat, and Low Carb Diets in NAFLD
3.2. Epigenetic Modulation of Nutrient Intake in NAFLD
3.2.1. Dietary One-Carbon Sources
3.2.2. Omega-3 PUFA and EVOO
3.2.3. δ-Tocotrienol and Trans-Resveratrol
3.2.4. Evidence-Based Dietary Recommendations for the Prevention and Management of NAFLD to the General Population
- I.
- Adopt a diet mainly plant-based and minimize saturated fats to reduce inflammation:Consume a diet that is mainly composed of plant-based food minimizing animal-derived nutrient sources rich in saturated fats, particularly red meat.
- II.
- High-fiber intake to stimulate gut microbiota and regulate fasting glucose:Increase consumption of high-fiber meals by incorporating a variety of fruits, vegetables, legumes, and whole grains into daily meals.
- III.
- Increase PUFAs and MUFAs fatty acids to optimize lipid profile:Increase the consumption of polyunsaturated fatty acids (PUFAs), specifically omega-3 fatty acids, by including oily fish such as salmon, sardines, or trout in the diet and add monounsaturated fatty acids (MUFAs) through the intake of extra-virgin olive oil, nuts, and seeds.
- IV.
- Limit consumption of highly processed food, soft drinks, and added fructose and salt to avoid and mitigate fatty liver accumulation.
- V.
- Avoid alcohol or keep its consumption below the risk threshold (30 g/day for men, 20 g/day for women).
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
List of Abbreviations
Acly | ATP citrate lyase |
AHA | American Heart Association |
ALP | Alkaline phosphatase |
BMI | Body mass index |
BW | Body weight |
CH3 | methyl group |
CR | Caloric restriction |
CVD | Cardiovascular disease |
DASH | Dietary Approaches to Stop Hypertension |
DHA | Docosaneic acid |
DNL | De-novo lipogenesis |
DNMTs | DNA methyltransferases |
DR | Dietary restriction |
ELCD | Exercise plus low carbohydrate diet |
EPA | Eicosapentaenoic acid |
EVOO | Extra virgin olive oil |
Ex | Exercise |
FA | Fatty acids |
GCKR | Glucokinase regulator |
HATs | Histone acetyltransferases |
HCC | Hepatocellular carcinoma |
HDACs | Hystone deacetylases |
HEI | Healthy Eating Index |
HSD17B13 | Hydroxysteroid 17-beta dehydrogenase 13 |
H3 | Histone 3 |
IF | Intermittent fasting |
Igfbp2 | Insulin-like growth factor binding protein 2 |
Igf1 | Insulin-like growth factor 1 |
IHF | Intrahepatic fat |
IR | Insulin resistance |
K | Lysine |
KD | Ketogenic diet |
K4 | Lysine 4 |
K9 | Lysine 9 |
K27 | Lysine 27 |
LCD | Low-carbohydrate diet |
LDs | Lipid droplets |
LF | Low fat |
MBOAT7 | Membrane-bound O-acyltransferase domain-containing 7 |
MedDiet | Mediterranean diet |
MED/LC | Mediterranean/Low carbohydrate diet |
MetS | Metabolic syndrome |
MUFA | Monounsaturated fatty acid |
miRNAs | Micro-RNAs |
NAFL | Non-alcoholic fatty liver |
NAFLD | Non-alcoholic fatty liver disease |
NASH | Non-alcoholic steatohepatitis |
PA | Physical activity |
PBMCs | Peripheral blood mononuclear cells |
PC | Pyruvate carboxylase |
PF | Periodic fasting |
PNPLA3 | Patatin-like phospholipase domain-containing 3 |
PUFA | Polyunsaturated fatty acid |
RESMENA | Restriction Mediterranean-based dietary intervention |
SAM | S-adenosylmethionine |
SDGs | Sustainable Development Goals |
SDGs | Sustainable Development Goals |
SIRTs | Sirtuins |
SIRT1 | Sirtuin 1 |
TG | Triglycerides |
TM6SF2 | Transmembrane 6 superfamily member 2 |
TRM | δ-tocotrienol and resveratrol mixture |
T2DM | Type 2 diabetes mellitus |
VLDL | Very low-density lipoproteins |
WBC | White blood cells |
WC | Waist circumference |
5mC | 5-methylcytosine |
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Diet Intervention | |||||||
---|---|---|---|---|---|---|---|
Low fat/low carb–MED diets | Study reference | Type of study | Intervention | Source of biological sample | Epigenetic mechanism | Epigenetic signature | Outcomes |
[43] | Sub-study of the CENTRAL randomized controlled trial | 120 participants from the CENTRAL trial were conducted to an 18-month regimen of either LF or MED/LC diets with 28 g/day of provided walnuts, with or without PA (PA+/PA−) | Blood cells | DNA methylation | 2095 different CpGs located among 41 genes were analyzed. Significant correlations for 5 CpG methylation in steatosis-related genes predicted NAFLD:
| After 18 months, significant reductions of IHF%, weight, and WC were observed, with no differences between diet groups LF and MED/LC | |
MED diet | [44] | Clinical trial | 18 participants with medium-to-high-grade steatosis trained to follow the Mediterranean diet, including fiber supplements | Blood cells | DNA methylation and Histone modification | Histone modifications: Reduced levels of H3 acetylation in monocytes and lymphocytes. DNA methylation: 11485 CpG sites hypermethylated; 142 hypomethylated | Improvement of the anthropometric, biochemical, and liver steatosis status. Genome-wide methylation patterns changed towards the pattern for healthy blood. Methylation changes in blood-separated liver biopsies from NAFLD patients according to the fibrosis grade |
Low-carb diet | [45] | Randomized controlled trial | 50–65-year-old participants with NAFLD and NASH were randomly assigned to four groups: Ex, LCD, exercise, ELCD, and No groups. 6-month intervention | Blood cells | DNA methylation | Differentially methylated CpGs before and after intervention: 100118 (Ex), 268582 (LCD), 270663 (ELCD) and 259249 (No) CpG After exclusion of No group: 430 (Ex), 2807 (LCD), and 1648 (ELCD) CpGs; 404 (Ex), 2661 (LCD), and 1575 (ELCD) genes | Lower methylation levels pre-intervention than post-intervention LCD and ELCD intervention on human NAFLD can induce DNA methylation alterations at critical genes in blood, e.g., GAB2 (validated in liver and adipose of NASH mice model) |
RESMENA hypocaloric-MED diet | [46] | Sub-study of the Randomized-prospective RESMENA study | 40 participants with MetS from the RESMENA study were evaluated before and after an 8 wk hypocaloric-MED diet | Blood cells | miRNA | Expression of miR-155-3p was decreased in WBC; Let-7b was upregulated after treatment. | RESMENA diet improved most anthropometric and biochemical features. Low consumption of lipids and saturated fat was associated with higher expression of let-7b after the nutritional intervention |
RESMENA hypocaloric-MED diet and AHA diet | [47] | Sub-study of the Randomized-prospective RESMENA study | 24 patients with MetS features from the RESMENA study were selected from two dietary groups: RESMENA or AHA diets. | Blood cells | miRNA | 49 miRNAs differentially expressed (35 from AHA and 14 from MD diet) miR-410, miR637, miR-214, and miR-190 with the most significant expression changes | After 8w intervention: Significant changes in anthropometric parameters (BW, BMI, WS, and waist/hip ratio) Improvement of metabolic profile |
Nutrient Intake | |||||||
---|---|---|---|---|---|---|---|
Study Reference | Type of Study | Participants | Nutrient Evaluation | Source of Biological Sample | Epigenetic Mechanism | Epigenetic Signature | Outcomes |
[48] | Case-control | 18 control participants and 47 patients with NAFLD | Methyl-donor nutrients | Liver biopsies | DNA methylation | Global DNA hypomethylation in patients with NAFLD | Significantly lower levels of global DNA methylation in patients with NAFLD than control participants; Global DNA methylation level decreased with the aggravation of hepatic inflammation grade and disease progression. Severity of NAFLD correlated positively with the serum homocysteine level |
[49] | Case-control | 35 diabetic and 60 nondiabetic obese subjects | Vitamin 12 and folate levels | Liver biopsies with or without signs of NAFLD | DNA methylation | 236 CpG sites (94%) hypomethylated and 15 sites (6%) hypermethylated in subjects with T2D | Significant sites in diabetic subjects were hypomethylated Significantly reduced circulating folate levels in the T2D compared with the nondiabetic subjects were observed |
[50] | Double Blind Randomized Placebo Controlled Clinical Trial (pilot) | 24 patients with NAFLD | n-3 PUFA capsules contained fish oil (503 mg of DHA + 102 mg of EPA) or placebo capsules (750 mg of oleic acid) | Blood | miR-122 | No changes in miR-122 circulating levels | n-3 PUFAs were incorporated in erythrocytes after six months of fish oil supplementary intake. n-3 PUFAs were effective in reducing ALP and liver fibrosis without altering the expression of circulating miR-122 in individuals with NAFLD |
[51] | Randomized, double-blind, placebo-controlled clinical trial | 52 patients with NAFLD | 4 g/day supplementation of fish oil (2100 mg EPA and 924 mg DHA) or placebo (oleic acid) over a 6-month period | Blood | miRNA-122 | Ongoing research: https://www.backuptrials.com/bt/default/index?keywords=RBR-8dp876 (accessed on 25 July 2024). | |
[52] | Controlled intervention trial | 12 healthy subjects and 12 patients with MetS | Acute high- and low-polyphenols EVOO intake (55 mL after 12 h of fasting)–single dose | Blood | miRNAs | Supressed miRNAs: miR-146b-5p; miR-19a-3p; miR-181b-5p; miR-107; miR-769-5p; miR-192-5p Upregulated miRNAs: miR-23b-3p; miR-519b-3p | Acute EVOO intake led to significant changes in gene and miRNA expression in PBMCs of both healthy subjects and patients with MetS (more significant in healthy) High-polyphenols EVOO led to more significant changes in gene and miRNA expression compared to low-polyphenols EVOO |
[53] | Randomized placebo-controlled trial | 82 patients with MetS | TRM group received 400 mg capsules (δ-tocotrienol 250 mg; Resveratrol 150 mg) and placebo received (cellulose 400 mg capsule) twice daily for 24 weeks | Blood | miRNAs | TRM supplementation resulted in a significant upregulation of miR-130b and miR-221, as well as downregulation of miR-122 | TRM supplementation improved MetS parameters, including central obesity, impaired fasting glucose, dyslipidemia, and hypertension |
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Martín Barraza, J.I.; Bars-Cortina, D. Dietary Pattern’s Role in Hepatic Epigenetic and Dietary Recommendations for the Prevention of NAFLD. Nutrients 2024, 16, 2956. https://doi.org/10.3390/nu16172956
Martín Barraza JI, Bars-Cortina D. Dietary Pattern’s Role in Hepatic Epigenetic and Dietary Recommendations for the Prevention of NAFLD. Nutrients. 2024; 16(17):2956. https://doi.org/10.3390/nu16172956
Chicago/Turabian StyleMartín Barraza, Josefina I., and David Bars-Cortina. 2024. "Dietary Pattern’s Role in Hepatic Epigenetic and Dietary Recommendations for the Prevention of NAFLD" Nutrients 16, no. 17: 2956. https://doi.org/10.3390/nu16172956